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In the wardroom, MajorKira and ChiefO'Brien examine the replicator as Quark enters, followed closely by Odo. Quark benignly asks what the problem is, and Kira shows him an advertisement for Quark's on the monitor. Although Quark doesn't see anything wrong with it, Odo reminds him such tampering is a class 3 offense. Before they can proceed, an angry Worf enters and approaches Quark accusingly. He shows a mug in which his prune juice came from the USS Defiant's replicator: it is a similar advertisement, and when Worf turns the mug sideways, it repeats the jingle from the monitor. Kira impatiently warns Quark to fix the replicators by the time she returns from the Gamma Quadrant, otherwise she will go to Quark's and makes it clear he'll be the one to pay. Quark then decides to help Chief O'Brien with purging the systems.

Lieutenant CommanderDax, Doctor Bashir, and Kira intercept a distress signal while on a bio-survey mission in the Gamma Quadrant. They divert to a planet near the border of Dominion space. Dax and Bashir beam down and find a long-ruined city, with people walking about going about their business all with blue welts on their face. Just then a woman named Norva with red lesions on her face approaches and collapses in front of the two in obvious pain begging to be taken to Trevean. As Bashir tries to give her something for her distress another man, Epran, approaches and tells Bashir that there's nothing he can do for Norva as "the blight has quickened in her".

Reaching the hospital (after Dax traded in her hair pin for transport), the two Starfleet officers find a very un-hospital-like atmosphere. Groups of people are all sitting on the floor, surrounding one person with red lesions who is enjoying a meal. An attendant, seeing Norva, tells his assistant that she has quickened and must be taken to Trevean. When Trevean enters, one of the people who is being celebrated thanks Trevean for allowing him to enjoy a decent meal and a good sleep after finding out he had quickened. Trevean then turns to Bashir and Dax and tells them that Norva didn't make it, and that if she had arrived sooner then he could have done something for her. He then tells them that the blight is always fatal, which confuses Bashir as Trevean had just said he might have been able to do something for her.

Bashir and Dax explain that they came to the planet answering a distress call and that they have sophisticated medical equipment. Trevean tells them that they once had equipment just as sophisticated, and tells them the story of the planet. Two centuries earlier, the planet was technologically advanced and the inhabitants were building great cities and traveling to neighboring worlds. When the Dominion came to the planet, the population attempted to resist but they paid the price. The Jem'Hadar came and destroyed the world, and the Dominion wanted to use the planet as an example to others who thought they could defy them and therefore infected them with the blight. Now everyone is born with the disease and the disease may randomly become active, or "quicken" at any point in a person's life. This is outwardly shown by the lesions turning red, and it means the person will die soon after. Trevean himself is one of the oldest surviving people.

Just then the man who thanked Trevean falls to the ground. While everyone else simply watches, Bashir instinctively moves to help but is restrained by the attendants. It turns out that when people quicken, they go to Trevean to have their death induced with herbs. Bashir and Dax are infuriated by this, and realize that he also killed Norva. Trevean tells them they've interfered with the man's death and orders them to leave. The officers are too shocked to argue.

Dax finds the distress beacon, which is automated and has actually been operating for over two hundred years. Bashir feels that there's nothing he can do for people who don't want their help and recommends leaving the planet when the meet a pregnant woman named Ekoria. Ekoria was in Trevean's "hospital" and is curious about Bashir, as she has never met a doctor. She tells Bashir she is pregnant, and due in two months. While this doesn't seem so long to him, she tells him it is, as the people get no warning as to when they will quicken. Just then the grim discussion is interrupted when Kira calls the two and gives them some bad news... two Jem'Hadar ships have been detected headed in their direction.

Back in the runabout, it emerges that the Jem'Hadar ships are moving between star systems on what is obviously a patrol route and will soon enter theirs. Kira suggests returning to the Alpha Quadrant and arranging for a relief mission with Starfleet, but that could takes weeks. Bashir references a recent case when, during a plague on a planet that was killing thousands, it took an hour to identify the pathogen and three days to inoculate the population. Kira is persuaded to leave the other two on the planet and will hide the runabout in a nearby nebula and return for them in a week.

After returning to the planet, Jadzia and Bashir are offered a place to stay and work by Ekoria. While setting up their equipment, Jadzia asks about a hanging painting of the city in happier times. Ekoria tells them that her husband painted it before he died the previous winter, and that he also painted a nearby mural of the same picture to give hope and inspiration to other people. Bashir finishes setting up and tells Ekoria he needs to run a scan on someone with the disease, to which Ekoria happily volunteers. Bashir begins the scan, and offers to show her a picture of her baby on the medical tricorder. Ekoria agrees, and looks on in wonder.

Later both Bashir and Dax are hard at work, and make their first important step when Bashir isolates the virus meaning he can start mapping it and possibly create an antigen. Ekoria offers them both food, and gives them the food that she was saving for her death. She tells them she feels she doesn't need it any longer.

Bashir now needs someone who has quickened however finding someone willing to help is proving easier said than done. Bashir then bumps into Epran who has now quickened. He is surprised they are still there and tells them he would have invited them to his death had he known him better. Bashir asks what if he didn't have to die at all? This catches the attention of Epran and a few other people. However Epran is skeptical and thinks it's going to cost him something, to which Bashir tells him that isn't true and proves his knowledge when he uses an osteogenic stimulator to fix a fracture in a boy's arm. Trevean arrives and says that others have promised a cure, and all they have done is taken food and clothes and left them with nothing, and the people who believed them all went to Trevean in the end. Bashir in turn assures Trevean and the others that he gives no guarantees about his efforts.

Returning to his makeshift lab, Bashir is despondent that he couldn't get any volunteers. Ekoria tells him that she used to wake up hoping she had quickened so she could go to Trevean but that changed when she learned she was pregnant. Now she wants to be there for her son when he grows up. Then Jadzia arrives, and it turns out that Epran has volunteered to be Bashir's test subject.

Later, Bashir has several people all in various stages of the disease and is making good progress. He instructs Ekoria in the use of a hypospray and she injects herself with its contents then moves onto everyone else. However he doesn't tell her that the hypo contains what he believes to be the antigen against the blight. Also, Epran has stopped responding to cordrazine for the pain and now has a device emitting an inhibitor field on his forehead. Jadzia tells Julian that he's been awake nonstop for days working on this and he should get some rest.

Going outside, Ekoria tells Bashir that Epran's white blood cell count increased, which Bashir confirms is a good sign. He then complements her on her good bedside manner, but she tells him she was just trying to be kind. Bashir tells her some people don't like to be around the sick because it reminds them of their own mortality and he can sometimes be the same. Ekoria reminds him that death gets everyone, but Bashir tells her it won't get Kukalaka, his teddy bear from when he was a young boy. He carried him around everywhere and one day when his leg ripped open he performed his first surgery at the age of five and stitched him back together. He then admits that Kukalaka now sits on a shelf in his quarters. Just then the moment is interrupted when Jadzia arrives panicked telling Bashir that something's wrong. He goes inside to find Epran in pain with new lesions on his face.

Epran now has several new lesions on his face and is in terrible pain as the virus has suddenly mutated. Almost certain the antigen hasn't caused it, Bashir uses a micro-cellular scanner to try and find out what's wrong. However when he passes the scanner over the affected area, several more welts suddenly emerge and inflame. The terrible truth hits Bashir... the EM fields from his instruments are what is causing the virus to mutate so violently. Just then another woman starts to scream quickly followed by everyone else, all suffering the same reaction, and Bashir screams for everything to be shut down. Jadzia and Ekoria scramble to switch everything off as Bashir tries to stop the mutation, but it's no use and Epran dies in horrible agony. Bashir then uses CPR to try and resuscitate Epran, and grows manic in his attempts to revive him well past the point of no return, forcing Jadzia to pull him back. Trevean enters having heard of what's happened and one of the women begs him for his help. Bashir tries to stop him but Trevean tells him not to interfere and gives the woman a vial of poison, allowing her to die. Then all the other patients start calling for Trevean and Bashir simply stands, devastated and unwilling to stop him.

The next morning, Bashir stands among the now-covered bodies of the people he was supposed to help and blames himself for what's happened. He knew there were changes in the viral sequence and should have realized what was happening. Jadzia tries to assure him that there was no way he could have known their instruments would cause the virus to react like that. Jadzia attempts to console him but it's no use, and he admits that he was looking forward to telling people he had cured the blight. But now he knows that there is no cure, the Dominion made sure of it and he was arrogant to think he could find a cure in a week. Jadzia tells him that might have been arrogant, but it's far more arrogant to think there is no cure just because he can't find it. Bashir is left alone to think things over.

Bashir then walks down the street and is reviled by the people but he doesn't acknowledge their hatred. He spots the mural of the city that he heard about and goes to look at it.

While looking at the picture of the city in happier times, Ekoria approaches Bashir from behind and tells him she's glad he got the chance to see it. He turns to look at her and is saddened to see that she has quickened. She thanks him for giving her hope, and she really thought she was going to make it to the end of her pregnancy. But now she is going to see Trevean and bids Bashir farewell. As she leaves however, Bashir asks her to wait, having had a change of heart.

The runabout has returned to the planet, but Bashir tells Kira and Jadzia he can't leave the people now. He is told to contact the station when he is ready and Jadzia bids him a fond farewell before he returns to the planet, alone.

Ekoria is now Bashir's only patient and after examining her (using old-fashioned and low-level equipment) he is confused to find no trace of the antigen in her system. He reasons that her immune system must have rejected it when suddenly Ekoria feels some pain from the blight. Bashir advises her against receiving any more cordrazine as there's already so much in her system it may harm the baby. She agrees to forgo it. Later, Bashir prepares a salve for her and takes the opportunity to examine the baby. He is growing stronger, and will be at term in six weeks. But it's clear that Ekoria isn't going to last that long, so Bashir tells her that the baby should be strong enough to survive in two weeks and then he'll induce labor.

Later Trevean visits Ekoria and offers her the chance to die, telling her that her child will only know peace. Ekoria refuses saying her child deserves a chance to live, and Bashir confronts him and asks why he's so obsessed with death given he's survived the blight longer than anyone. Trevean responds that the reason he's obsessed with death is because he's seen so much of it, as well as so much suffering because of it. He wishes Ekoria well and hopes she lives to see her baby. He leaves, and Bashir begins to appreciate his situation.

Ekoria has made it past the two weeks and is now giving birth to her baby with Bashir as the midwife. She pushes as hard as she can, and gives birth to a baby boy but the effort takes almost all the life out of her. Bashir cleans the child and is astonished to find no lesions on the child's body... he is free of the blight. Bashir realizes the antigen must have been absorbed through the placenta and immunized him to the disease; although he couldn't find a cure, he has made a vaccine. Ekoria smiles, happy that her son will live a full life, but then she finally dies. Bashir is torn between his joy and devastation.

Bashir reports the news to an astounded Trevean, and tells him that all pregnant women must be given the antigen immediately. The people cannot be saved, but their children can. Trevean promises to make sure the antigen gets to everyone and holds the child, a beacon of hope in their devastated world.

Back on Deep Space 9, Bashir is working hard late into the night analyzing the virus when CaptainSisko enters after reading Bashir's report and warmly congratulates him on a job well done. Bashir thanks him, but it doesn't make him feel any better about the people still dying on that world. Sisko reminds Bashir that, because of him, their children will not suffer in the same way. Bashir knows, but it's small comfort. Sisko nods his understanding and leaves Bashir alone to his work and the doctor continues his efforts to find a true cure.

"I ordered a glass of prune juice from the replicator in the Defiant's mess. This is what it came in."

- Worf, to Quark on the Ferengi advertisement on Worf's mug

"If all your little advertisements aren't purged from our systems by the time I get back from the Gamma Quadrant, I will come to Quark's, and believe me, I will have fun."

- Kira, to Quark

"I canceled my death for you. I was really looking forward to it."

- Epran agreeing to be treated by Bashir

"You killed her."
"I did what she asked."
"I thought this was a hospital, and that you were a healer."
"I am. I take away pain."

- Bashir and Trevean, referring to euthanasia

"Trevean was right. There is no cure. The Dominion made sure of that. But I was so arrogant, I thought I could find one in a week!"
"Maybe it was arrogant to think that. But it's even more arrogant to think there isn't a cure just because you couldn't find it."

The concept for this episode originated with Ira Steven Behr after watching the 1995Michael Hoffman film Restoration. The theme of the movie, and the idea that Behr wanted to bring to the world of Deep Space Nine, was what would happen when an inherently moral doctor is placed in a situation he is unable to control. This led Behr to propose that Bashir should be placed in the middle of a planet-wide epidemic, and no matter how hard he tries, he simply cannot come up with a cure. Also on Behr's mind was the fact that Gregg Duffy Long, an office assistant, had just died of AIDS. According to Behr, "My wife Laura works closely with AIDS Project Los Angeles, and the whole AIDS thing was on all of our minds, so we just wanted to come up with a disease that breaks your heart." Because he was too busy himself, Behr hired Naren Shankar to write the teleplay, although Shankar ultimately decided to drop the AIDS metaphor; "I didn't give the sense that the people were outcasts or pariahs, which is how AIDS patients are often perceived." (Star Trek: Deep Space Nine Companion, pp. 342-343)

The working title of this episode was "The Healing Touch". This title was given to the episode by writer Naren Shankar, but it was changed by René Echevarria because the producers felt that it implied Bashir would be successful in his fight against the blight. Echevarria chose the new title of "The Quickening" as a pun. In the context of the episode, 'to quicken' means that the disease has become active, but 'to quicken', in reality, also means to come alive, so the title refers to both death and birth. Echevarria was particularly proud of this double meaning. (Star Trek: Deep Space Nine Companion, p. 343)

The name of Kukalaka was chosen by René Echevarria. However, it came from a mistake on his part. According to Echevarria, he thought Kukalaka was the name of his best friend's invisible childhood friend, but after the friend saw the episode, he informed Echevarria that Kukalaka was actually the name of a cat belonging to an ex-girlfriend of his. (Star Trek: Deep Space Nine Companion, p. 344)

Trevean is an anagram for "veteran" and Ekorio (the original name of Ekoria) is an anagram for "rookie". These names were created by Naren Shankar, who noted, "Small things like that help me to focus when I'm creating characterization." (Star Trek: Deep Space Nine Companion, p. 343)

This episode was filmed prior to "To the Death", but it aired a week later.

The previous episode directed by Rene Auberjonois was "Hippocratic Oath", and like that show, this one had a great deal of problems. In particular, at one stage, the set was destroyed by rain, which pushed shooting back by three days as the sets were rebuilt. As well as that, there were seventy extras on-set, Auberjonois had never shot on location before, and he had never used a crane before. However, whereas he hated the pressure of directing "Hippocratic Oath", he reacted differently this time; "You'd think that's where I'd fall apart, but this was, for me, my breakthrough as a director. It's the first time I really had a handle on it." (Star Trek: Deep Space Nine Companion, pp. 343-344)

Director Rene Auberjonois saw this show as having strong religious overtones. In particular, he felt that the character of Ekoria was a Virgin Mary type figure, and he tried to place her in the frame in such a manner as to recall Renaissance holy pictures. One shot in particular, of her standing in front of a rounded arch window, was designed in such a way as to make the arch look like a halo. According to Auberjonois in relation to this shot, "we tried to get a sort of Vermeer look to it." (Star Trek: Deep Space Nine Companion, p. 343)

Most of the later-stage disfiguring caused by the Teplan blight was done in post-production by multilayer compositing under the supervision of Gary Hutzel. This meant that on-set, rather than elaborate make-up, actors had dots attached to their faces which allowed their motion to be recorded precisely and which could then be replicated exactly in a computer. This was an early form of the type of sophisticated motion capture software and motion capture suits that are used regularly today. (Star Trek: Deep Space Nine Companion, p. 344-345)

The picture of Quark on Worf's mug is a promotional shot of Armin Shimerman taken during the production of "Emissary", the first episode of Deep Space Nine. At that time, Shimerman was still wearing the nose made for Rom, played by Max Grodénchik, which is why the picture looks slightly different from Quark's actual appearance.

All of the outdoor scenes were shot at the Santa Susana Field Laboratory in Ventura County, Southern California, where Rocketdyne had performed shuttle testings that resulted in the Earth being burned and scorched due to the heat and flames of rocket engines. (Deep Space Nine Chronicles)

This episode is a favorite of Alexander Siddig's. He commented, "This story was a lesson in abject arrogance and how blinding it can be. Prior to this episode, Bashir had only succeeded. He always won. He always got his man. So it was very interesting for him not to be able to do that." Ira Steven Behr agrees with Siddig's appraisal; "it was a horror story basically. It's about this genetically engineered plague and the hubris of a doctor who thought that he could just come in and be a hero." (Star Trek: Deep Space Nine Companion, p. 344)

In the Special Features, Hidden File 01 on the DS9 Season 4 DVD, Alexander Siddig elaborates on why he loves this episode so much; "I loved that show, I mean I loved doing it, and Rene directed it, he was great at directing that show. I really enjoyed the fact that there's this doctor that turns up on this planet and he is so arrogant and full of himself that he thinks he can cure the planet of all their diseases, and probably get whatever the equivalent of the Nobel Prize is. And he fails, he kills a bunch of people, a whole bunch of people die because he screwed up. That doesn't happen on TV. The good guys don't screw up. And I love the fact that it all went horribly wrong and he had to, you know, go back to the drawing board and figure out where he went wrong. 'Maybe it's because I was terribly arrogant, maybe it's because I put my own interests above those of my patients'. That's a great lesson for any doctor."

Terry Farrell also thought the episode was exceptional, commenting that it was: "a good one to work on because I was thinking about the AIDS metaphor while we were shooting it. I felt like we had a touch of reality in that episode. Sid was so good. Bashir's ego was really driven to cure that disease. I thought it was interesting that Dax was a step back and more realistic than Bashir. She thought you should do everything you can, but, at the day's end, felt you had to let it go a little bit so you had the strength to come back the next day and be fresh enough to try again. It was a great show, probably one of our best". (The Official Star Trek: Deep Space Nine Magazine Vol. 18)

Ira Behr was also fond of this episode, commenting, "A lot of things really came together in 'The Quickening'. I mean, the sets were unbelievable. The production values did not let us down. So much of it worked!" (Star Trek: Deep Space Nine Companion, p. 343)

When asked which DS9 episode he contributed to was his favorite, René Echevarria named "The Quickening" as a close second behind "The Visitor". [X]wbm